An Introduction to Interstitial Cystitis (Part 1)

Interstitial Cystitis (IC), aka Bladder Pain Syndrome (BPS), is a chronic life-altering bladder condition that is identified by bladder pressure and mild to severe bladder and pelvic pain for over 6 weeks without explanation. The condition can affect anyone, although ages of commonly diagnosed individuals range between 20 and 50.

How It Happens:

IC occurs when there is a communication error between the brain and the bladder. Instead of signaling the brain for urination when it is full, the bladder sends signals at different times, resulting in frequent urges to urinate in small volumes, which also causes pain, throughout the day.

Symptoms:

While they may resemble Urinary Tract Infections (UTIs), bacterial infections are not observed in IC, with some common symptoms being:

• Pelvic pain along with pain between the vagina and anus in women, or in the scrotum, testicles, penis and/or anus in men.
• Bladder pain that recurs after weeks or months.
• Painful sex
• Frequent day and night urination in smaller amounts more than 10 times a day.
• Urinary urgency
• Pain or discomfort as the bladder refills, that is relieved after urinating.

Note: The frequency and intensity of symptoms vary from person to person, which may also ‘flare up’ due to certain triggers or at certain times. Examples include menstruation, stress, strenuous exercise, prolonged sitting, and sexual activity.

Causes:

While the exact cause of IC is unknown, commonly proposed theories include:

• Bladder irritation and damage from chemical substances in urine caused by bladder tissue defects.
• The release of histamine and other chemicals by mast cells (specific inflammatory cells).
• Abnormalities in nerves that transmit messages from the brain to the bladder that result in painful sensations triggered by otherwise non-painful actions.
• Autoimmune attacks on the bladder.
• In concurrence with Irritable Bowel or Chronic Fatigue Syndromes, lupus, fibromyalgia, and Vulvodynia (chronic vulvar pain in women).

Complications:

IC can cause a number of complications if left untreated, some of which are:

• Low life quality and lowered sexual libido due to pain and frequent urination.
• Emotional stress and depression due to a disrupted sleep cycle caused by regular and frequent night urination.
• Reduced urine storage capacity due to stiffening of the bladder wall.

Diagnosis:

In addition to a pelvic exam, and urine test to check for UTIs and cancer (in which case it is known as ‘Urine Cytology’), the following tests may aid in an IC diagnosis:

1- Cystoscopy:

In order to observe the bladder lining for signs of damage, a thin tube attached to a small camera is inserted via the urethra. Additionally, hydrodistention, i.e. injecting a liquid into the bladder after general anesthesia may also be performed for bladder examination. Moreover, a small tissue sample from the bladder and urethra may also be removed (Biopsy) during cystoscopy to test for bladder cancer and other rare conditions.

2- Urodynamic Evaluation:

Since small bladder capacity and pain during bladder filling is a common sign of IC, filling and draining the bladder with water via a small catheter to measure bladder pressure while it fills and empties can help diagnose the condition.

3- Potassium Sensitivity Test:

Using pain as a determining factor, two solutions of water and potassium chloride are inserted into the bladder one after the other. Since non-IC individuals feel no pain when either solution is inserted, experiencing pain and urinary urgency upon inserting the potassium solution may indicate an IC diagnosis.

If not treated properly, Interstitial Cystitis can drastically affect quality of life. Therefore, if you observe any of the above symptoms, get examined as soon as possible. You can also book an appointment with a top Urologist in Karachi, Peshawar and Islamabad through oladoc.com, or call our helpline at 042-3890-0939 for assistance to find the RIGHT Doctor for your bladder troubles.